Steerable laser probe

ABSTRACT

A steerable laser probe may include a handle having a handle distal end and a handle proximal end, an actuation control of the handle, a flexible housing tube having a flexible housing tube distal end and a flexible housing tube proximal end, an optic fiber disposed within an inner portion of the handle and the flexible housing tube, and a cable disposed within the flexible housing tube and the actuation control. A rotation of the actuation control may be configured to gradually curve the flexible housing tube and the optic fiber. A rotation of the actuation control may be configured to gradually straighten the flexible housing tube and the optic fiber.

CROSS-REFERENCE TO RELATED APPLICATIONS

This Application is a continuation of prior application Ser. No.13/974,900, filed Aug. 23, 2013.

FIELD OF THE INVENTION

The present disclosure relates to a surgical instrument, and, moreparticularly, to a steerable laser probe.

BACKGROUND OF THE INVENTION

A wide variety of ophthalmic procedures require a laser energy source.For example, ophthalmic surgeons may use laser photocoagulation to treatproliferative retinopathy. Proliferative retinopathy is a conditioncharacterized by the development of abnormal blood vessels in the retinathat grow into the vitreous humor. Ophthalmic surgeons may treat thiscondition by energizing a laser to cauterize portions of the retina toprevent the abnormal blood vessels from growing and hemorrhaging.

In order to increase the chances of a successful laser photocoagulationprocedure, it is important that a surgeon is able aim the laser at aplurality of targets within the eye, e.g., by guiding or moving thelaser from a first target to a second target within the eye. It is alsoimportant that the surgeon is able to easily control a movement of thelaser. For example, the surgeon must be able to easily direct a laserbeam by steering the beam to a first position aimed at a first target,guide the laser beam from the first position to a second position aimedat a second target, and hold the laser beam in the second position.Accordingly, there is a need for a surgical laser probe that can beeasily guided to a plurality of targets within the eye.

BRIEF SUMMARY OF THE INVENTION

The present disclosure presents a steerable laser probe. In one or moreembodiments, a steerable laser probe may comprise a handle having ahandle distal end and a handle proximal end, an actuation control of thehandle, a flexible housing tube having a flexible housing tube distalend and a flexible housing tube proximal end, an optic fiber disposedwithin an inner portion of the handle and the flexible housing tube, anda cable disposed within the flexible housing tube and the actuationcontrol. Illustratively, a rotation of the actuation control may beconfigured to gradually curve the flexible housing tube. In one or moreembodiments, a gradual curving of the flexible housing tube may beconfigured to gradually curve the optic fiber. Illustratively, arotation of the actuation control may be configured to graduallystraighten the flexible housing tube. In one or more embodiments, agradual straightening of the flexible housing tube may be configured togradually straighten the optic fiber.

BRIEF DESCRIPTION OF THE DRAWINGS

The above and further advantages of the present invention may be betterunderstood by referring to the following description in conjunction withthe accompanying drawings in which like reference numerals indicateidentical or functionally similar elements:

FIGS. 1A and 1B are schematic diagrams illustrating an actuationcontrol;

FIGS. 2A and 2B are schematic diagrams illustrating an exploded view ofa handle assembly;

FIGS. 3A and 3B are schematic diagrams illustrating a handle;

FIG. 4 is a schematic diagram illustrating a flexible housing tube;

FIG. 5 is a schematic diagram illustrating an exploded view of asteerable laser probe assembly;

FIGS. 6A, 6B, 6C, 6D, and 6E are schematic diagrams illustrating agradual curving of an optic fiber;

FIGS. 7A, 7B, 7C, 7D, and 7E are schematic diagrams illustrating agradual straightening of an optic fiber.

DETAILED DESCRIPTION OF AN ILLUSTRATIVE EMBODIMENT

FIGS. 1A and 1B are schematic diagrams illustrating an actuation control100. FIG. 1A illustrates a side view of an actuation control 100.Illustratively, actuation control 100 may comprise an actuation controldistal end 101, an actuation control proximal end 102, an actuationcontrol anterior end 103, and an actuation control posterior end 104.FIG. 1B illustrates a cross-sectional view of an actuation control 100.In one or more embodiments, actuation control 100 may comprise afixation pin guide 110, a cable housing 120, and an actuation chamber130. Illustratively, actuation control 100 may be manufactured from anysuitable material, e.g., polymers, metals, metal alloys, etc., or fromany combination of suitable materials.

FIGS. 2A and 2B are schematic diagrams illustrating an exploded view ofa handle assembly 200. FIG. 2A illustrates a side view of a handleassembly 200. In one or more embodiments, handle assembly 200 maycomprise a handle end cap 205 having a handle end cap distal end 206 anda handle end cap proximal end 207, an actuation control mount 210 havingan actuation control mount distal end 211 and an actuation control mountproximal end 212, an actuation control 100, a fixation pin 215, a handlebase 220 having a handle base distal end 221 and a handle base proximalend 222, and a handle end cap interface 225. Illustratively, actuationcontrol 100 may be disposed within actuation control mount 210. In oneor more embodiments, fixation pin 215 may be configured to fix actuationcontrol 100 within actuation control mount 210, e.g., fixation pin 215may be disposed within a portion of actuation control mount 210 andwithin a portion of actuation control 100. Illustratively, fixation pin215 may be disposed within actuation control mount 210 and fixation pinguide 110. In one or more embodiments, actuation control 100 may berotated about fixation pin 215, e.g., a surgeon may rotate actuationcontrol 100 within actuation control mount 210 by applying a force to aportion of actuation control 100.

FIG. 2B illustrates a cross-sectional view of a handle assembly 200.Illustratively, handle assembly 200 may comprise a handle inner portion240, an auto-fixing component housing 245, and a flexible housing tubehousing 250. In one or more embodiments, actuation control 100 may beoriented wherein a portion of actuation chamber 130 may be disposedwithin a portion of handle inner portion 240. Illustratively, handle endcap 205, actuation control mount 210, and handle base 220 may bemanufactured from any suitable material, e.g., polymers, metals, metalalloys, etc., or from any combination of suitable materials.

FIGS. 3A and 3B are schematic diagrams illustrating a handle 300. FIG.3A illustrates a side view of a handle 300. Illustratively, handle 300may comprise a handle distal end 301 and a handle proximal end 302. Inone or more embodiments, handle distal end 301 may comprise a portion ofhandle base 220, e.g., handle distal end 301 may comprise handle basedistal end 221. Illustratively, handle proximal end 302 may comprise aportion of end cap 205, e.g., handle proximal end 302 may comprisehandle end cap proximal end 207.

FIG. 3B illustrates a cross-sectional view of a handle 300. In one ormore embodiments, actuation control mount 210 may be disposed withinhandle end cap 205 and handle base 220. Illustratively, actuationcontrol mount 210 may be disposed within handle end cap 205 and handlebase 220 wherein a portion of actuation control 100 may be adjacent to aportion of auto-fixing component housing 245. In one or moreembodiments, a portion of handle base 220 may be disposed within aportion of handle end cap 205, e.g., handle base proximal end 222 may bedisposed within handle end cap 205. In one or more embodiments, aportion of handle base 220 may be disposed within handle end cap 205wherein handle end cap interface 225 may be configured to interface witha portion of handle end cap 205, e.g., handle end cap interface 225 maybe configured to interface with handle end cap distal end 206.Illustratively, a portion of handle base 220 may be fixed within handleend cap 205, e.g., by an adhesive or any suitable fixation means. In oneor more embodiments, a portion of handle base 220 may be fixed withinhandle end cap 205 by a press fit, a setscrew, a weld, etc.Illustratively, handle base 220 and handle end cap 205 may bemanufactured as a single unit.

FIG. 4 is a schematic diagram illustrating a flexible housing tube 400.Illustratively, flexible housing tube 400 may comprise a flexiblehousing tube distal end 401 and a flexible housing tube proximal end402. Flexible housing tube 400 may be manufactured from any suitablematerial, e.g., polymers, metals, metal alloys, etc., or from anycombination of suitable materials. Illustratively, flexible housing tube400 may comprise a shape memory material, e.g., Nitinol. In one or moreembodiments, flexible housing tube 400 may be manufactured from amaterial having an ultimate tensile strength between 700 and 1000 MPa.Illustratively, flexible housing tube 400 may be manufactured from amaterial having ultimate tensile strength less than 700 MPa or greaterthan 1000 MPa. In one or more embodiments, flexible housing tube 400 maybe manufactured from a material having a modulus of elasticity between30 and 80 GPa. Illustratively, flexible housing tube 400 may bemanufactured from a material having a modulus of elasticity less than 30GPa or greater than 80 GPa.

In one or more embodiments, flexible housing tube 400 may bemanufactured with dimensions suitable for performing microsurgicalprocedures, e.g., ophthalmic surgical procedures. Illustratively,flexible housing tube 400 may be manufactured at gauge sizes commonlyused in ophthalmic surgical procedures, e.g., 23 gauge, 25 gauge, etc.In one or more embodiments, flexible housing tube 400 may be configuredto be inserted in a cannula, e.g., a cannula used during an ophthalmicsurgical procedure. For example, one or more properties of flexiblehousing tube 400 may be optimized to reduce friction as flexible housingtube 400 is inserted into a cannula. In one or more embodiments, one ormore properties of flexible housing tube 400 may be optimized to reducefriction as flexible housing tube 400 is removed from a cannula.Illustratively, flexible housing tube 400 may have an ultimate tensilestrength between 1000 MPa and 1100 MPa. In one or more embodiments,flexible housing tube 400 may have an ultimate tensile strength lessthan 1000 MPa or greater than 1100 MPa.

In one or more embodiments, an optic fiber 450 may be disposed withinflexible housing tube 400. Illustratively, optic fiber 450 may comprisean optic fiber distal end 451 and an optic fiber proximal end 452. Inone or more embodiments, optic fiber 450 may be configured to transmitlight, e.g., laser light. Illustratively, optic fiber 450 may bedisposed within flexible housing tube 400 wherein optic fiber distal end451 may be adjacent to flexible housing tube distal end 401. In one ormore embodiments, a portion of optic fiber 450 may be fixed to a portionof flexible housing tube 400, e.g., by an adhesive or any suitablefixation means.

Illustratively, a cable 410 may be disposed within flexible housing tube400. In one or more embodiments, cable 410 may comprise a cable distalend 411 and a cable proximal end 412. Illustratively, cable 410 may bedisposed within flexible housing tube 400 wherein cable distal end 411may be adjacent to flexible housing tube distal end 401. In one or moreembodiments, cable 410 may be fixed to a portion of housing tube 400,e.g., by an adhesive or any suitable fixation means. For example, aportion of cable 410 may be fixed to a portion of flexible housing tube400 by a weld, a press fit, a loop, a tie, etc.

FIG. 5 is a schematic diagram illustrating an exploded view of asteerable laser probe assembly 500. In one or more embodiments, asteerable laser probe assembly 500 may comprise a handle 300 having ahandle distal end 301 and a handle proximal end 302, a flexible housingtube 400 having a flexible housing tube distal end 401 and a flexiblehousing tube proximal end 402, a cable 410 having a cable distal end 411and a cable proximal end 412, an optic fiber 450 having an optic fiberdistal end 451 and an optic fiber proximal end 452, an auto-fixingcomponent 520 having an auto-fixing component distal end 521 and anauto-fixing component proximal end 522, and a light source interface510. Illustratively, light source interface 510 may be configured tointerface with optic fiber 450, e.g., at optic fiber proximal end 452.In one or more embodiments, light source interface 510 may comprise astandard light source connector, e.g., an SMA connector.

Illustratively, a portion of flexible housing tube 400 may be disposedwithin a portion of handle 300, e.g., flexible housing tube proximal end402 may be disposed within a portion of handle 300. In one or moreembodiments, a portion of flexible housing tube 400 may be disposedwithin a portion of handle base 220, e.g., flexible housing tubeproximal end 402 may be disposed in flexible housing tube housing 250.Illustratively, a portion of flexible housing tube 400 may be fixedwithin a portion of handle 300, e.g., flexible housing tube proximal end402 may be fixed within flexible housing tube housing 250. In one ormore embodiments, a portion of flexible housing tube 400 may be fixedwithin flexible housing tube housing 250, e.g., by an adhesive or anysuitable fixation means. For example, a portion of flexible housing tube400 may be fixed within flexible housing tube housing 250 by a pressfit, a set screw, etc.

Illustratively, optic fiber 450 may be disposed within handle innerportion 240, actuation chamber 130, flexible housing tube housing 250,and flexible housing tube 400. In one or more embodiments, optic fiber450 may be disposed within flexible housing tube 400 wherein optic fiberdistal end 451 may be adjacent to flexible housing tube distal end 401.Illustratively, a portion of optic fiber 450 may be fixed to a portionof flexible housing tube 400, e.g., by an adhesive or any suitablefixation means. In one or more embodiments, cable 410 may be disposedwithin cable housing 120, actuation chamber 130, handle inner portion240, flexible housing tube housing 250, and flexible housing tube 400.Illustratively, cable 410 may be disposed within flexible housing tube400 wherein cable distal end 411 may be adjacent to flexible housingtube distal end 401. In one or more embodiments, a portion of cable 410may be fixed to a portion of flexible housing tube 400, e.g., by anadhesive or any suitable fixation means. For example, a portion of cable410 may be fixed to a portion of flexible housing tube 400 by a weld, apress fit, a loop, a tie, etc. In one or more embodiments, a portion ofcable 410 may be fixed within cable housing 120, e.g., by an adhesive orany suitable fixation means. For example, a portion of cable 410 may befixed within cable housing 120 by a weld, a press fit, a loop, a tie,etc. Illustratively, a first portion of cable 410 may be fixed to aportion of flexible housing tube 400 and a second portion of cable 410may be fixed within cable housing 120. In one or more embodiments, cabledistal end 411 may be fixed to a portion of flexible housing tube 400.Illustratively, cable proximal end 412 may be fixed within cable housing120.

In one or more embodiments, a surgeon may rotate actuation control 100within handle inner portion 240, e.g., by applying a force to a portionof actuation control 100. Illustratively, actuation chamber 130 may beconfigured to prevent a contact between a portion of actuation control100 and a portion of optic fiber 450, e.g., due to a rotation ofactuation control 100. In one or more embodiments, a geometry ofactuation chamber 130 may be configured to prevent a contact between aportion of actuation control 100 and a portion of optic fiber 450, e.g.,due to a rotation of actuation control. Illustratively, a surgeon mayrotate actuation control 100 about fixation pin 215, e.g., by applying aforce to a portion of actuation control 100. In one or more embodiments,a rotation of actuation control 100 may be configured to retract cable410 relative to flexible housing tube 400. Illustratively, a retractionof cable 410 relative to flexible housing tube 400 may be configured toapply a force to a portion of flexible housing tube 400. In one or moreembodiments, an application of a force to a portion of flexible housingtube 400 may be configured to compress a portion of flexible housingtube 400. Illustratively, a compression of a portion of flexible housingtube 400 may be configured to cause flexible housing tube 400 togradually curve. In one or more embodiments, a gradual curving offlexible housing tube 400 may be configured to gradually curve opticfiber 450. Illustratively, a rotation of actuation control 100 may beconfigured to gradually curve optic fiber 450.

In one or more embodiments, a rotation of actuation control 100 may beconfigured to extend cable 410 relative to flexible housing tube 400.Illustratively, an extension of cable 410 relative to flexible housingtube 400 may be configured to reduce a force applied to a portion offlexible housing tube 400. In one or more embodiments, a reduction of aforce applied to a portion of flexible housing tube 400 may beconfigured to decompress a portion of flexible housing tube 400.Illustratively, a decompression of a portion of flexible housing tube400 may be configured to cause flexible housing tube 400 to graduallystraighten. In one or more embodiments, a gradual straightening offlexible housing tube 400 may be configured to gradually straightenoptic fiber 450. Illustratively, a rotation of actuation control 100 maybe configured to gradually straighten optic fiber 450.

In one or more embodiments, auto-fixing component 520 may be disposedwithin auto-fixing component housing 245. Illustratively, auto-fixingcomponent 520 may be fixed within auto-fixing component housing 245,e.g., by an adhesive or any suitable fixation means. In one or moreembodiments, auto-fixing component 520 may be disposed withinauto-fixing component housing 245 wherein a portion of auto-fixingcomponent 520 may be adjacent to a portion of actuation control 100.Illustratively, auto-fixing component 520 may be configured to produce amagnetic field, e.g., auto-fixing component 520 may comprise a permanentmagnet. In one or more embodiments, auto-fixing component 520 maycomprise a ferromagnetic material, e.g., auto-fixing component 520 maycomprise a ferrimagnetic material. Illustratively, actuation control 100may be configured to produce a magnetic field, e.g., actuation control100 may comprise a permanent magnetic. In one or more embodiments,actuation control 100 may comprise a ferromagnetic material, e.g.,actuation control 100 may comprise a ferrimagnetic material.

Illustratively, auto-fixing component 520 may be configured totemporarily fix actuation control 100 in a rotational position withinhandle inner portion 240, e.g., a magnetic force attracting actuationcontrol 100 to auto-fixing component 520 may be configured to holdactuation control 100 fixed in a rotational position within handle innerportion 240. In one or more embodiments, actuation control 100 may beconfigured to temporarily fix actuation control 100 in a rotationalposition within handle inner portion 240, e.g., a magnetic forceattracting auto-fixing component 520 to actuation control 100 may beconfigured to temporarily hold actuation control 100 fixed in arotational position within handle inner portion 240. Illustratively,both auto-fixing component 520 and actuation control 100 may beconfigured to temporarily fix actuation control 100 in a rotationalposition within handle inner portion 240, e.g., auto-fixing component520 and actuation control 100 may both comprise permanent magnets havingpoles oriented to attract auto-fixing component 520 to actuation control100 and to attract actuation control 100 to auto-fixing component 520.

In one or more embodiments, a surgeon may actuate actuation control 100within handle inner portion 240, e.g., by applying a force to a portionof actuation control 100 until actuation control 100 is in a firstdesired rotational position within handle inner portion 240.Illustratively, the surgeon may then remove the force applied toactuation control 100 and perform a portion of a surgical procedure,e.g., actuation control 100 and auto-fixing component 520 may beconfigured to temporarily fix actuation control 100 in the first desiredrotational position within handle inner portion 240. In one or moreembodiments, the surgeon may actuate actuation control 100 within handleinner portion 240, e.g., by applying a force to a portion of actuationcontrol 100 until actuation control 100 is in a second desiredrotational position within handle inner portion 240. Illustratively, thesurgeon may then remove the force applied to actuation control 100 andperform a portion of a surgical procedure, e.g., actuation control 100and auto-fixing component 520 may be configured to temporarily fixactuation control 100 in the second desired rotational position withinhandle inner portion 240. In one or more embodiments, the surgeon mayactuate actuation control 100 within handle inner portion 240, e.g., byapplying a force to a portion of actuation control 100 until actuationcontrol 100 is in a third desired rotational position within handleinner portion 240. Illustratively, the surgeon may then remove the forceapplied to actuation control 100 and perform a portion of a surgicalprocedure, e.g., actuation control 100 and auto-fixing component 520 maybe configured to temporarily fix actuation control 100 in the thirddesired rotational position within handle inner portion 240. In one ormore embodiments, actuation control 100 and auto-fixing component 520may be configured to temporarily fix actuation control 100 in anydesired rotational position within handle inner portion 240.

FIGS. 6A, 6B, 6C, 6D, and 6E are schematic diagrams illustrating agradual curving of an optic fiber 450. FIG. 6A illustrates a straightoptic fiber 600. In one or more embodiments, optic fiber 450 maycomprise a straight optic fiber 600, e.g., when cable 410 is fullyextended relative to flexible housing tube 400. Illustratively, a linetangent to optic fiber distal end 451 may be parallel to a line tangentto flexible housing tube proximal end 402, e.g., when optic fiber 450comprises a straight optic fiber 600. In one or more embodiments,actuation control 100 and auto-fixing component 520 may be configured totemporarily fix actuation control 100 in a first fixed rotationalposition within handle inner portion 240. Illustratively, optic fiber450 may comprise a straight optic fiber 600, e.g., when actuationcontrol 100 is fixed in the first fixed rotational position withinhandle inner portion 240.

FIG. 6B illustrates an optic fiber in a first curved position 610. Inone or more embodiments, a rotation of actuation control 100 withinhandle inner portion 240 may be configured to gradually curve opticfiber 450 from a straight optic fiber 600 to an optic fiber in a firstcurved position 610. Illustratively, a rotation of actuation control 100within handle inner portion 240 may be configured to retract cable 410relative to flexible housing tube 400. In one or more embodiments, aretraction of cable 410 relative to flexible housing tube 400 may beconfigured to apply a force to a portion of flexible housing tube 400.Illustratively, an application of a force to a portion of flexiblehousing tube 400 may be configured to compress a portion of flexiblehousing tube 400. In one or more embodiments, a compression of a portionof flexible housing tube 400 may be configured to gradually curveflexible housing tube 400. Illustratively, a gradual curving of flexiblehousing tube 400 may be configured to gradually curve optic fiber 450,e.g., from a straight optic fiber 600 to an optic fiber in a firstcurved position 610. In one or more embodiments, a line tangent to opticfiber distal end 451 may intersect a line tangent to flexible housingtube proximal end 402 at a first angle, e.g., when optic fiber 450comprises an optic fiber in a first curved position 610. In one or moreembodiments, the first angle may comprise any angle greater than zerodegrees. For example, the first angle may comprise a 45 degree angle.Illustratively, actuation control 100 and auto-fixing component 520 maybe configured to temporarily fix actuation control 100 in a second fixedrotational position within handle inner portion 240. In one or moreembodiments, optic fiber 450 may comprise an optic fiber in a firstcurved position 610, e.g., when actuation control 100 is fixed in thesecond fixed rotational position within handle inner portion 240.

FIG. 6C illustrates an optic fiber in a second curved position 620. Inone or more embodiments, a rotation of actuation control 100 withinhandle inner portion 240 may be configured to gradually curve opticfiber 450 from an optic fiber in a first curved position 610 to an opticfiber in a second curved position 620. Illustratively, a rotation ofactuation control 100 within handle inner portion 240 may be configuredto retract cable 410 relative to flexible housing tube 400. In one ormore embodiments, a retraction of cable 410 relative to flexible housingtube 400 may be configured to apply a force to a portion of flexiblehousing tube 400. Illustratively, an application of a force to a portionof flexible housing tube 400 may be configured to compress a portion offlexible housing tube 400. In one or more embodiments, a compression ofa portion of flexible housing tube 400 may be configured to graduallycurve flexible housing tube 400. Illustratively, a gradual curving offlexible housing tube 400 may be configured to gradually curve opticfiber 450, e.g., from an optic fiber in a first curved position 610 toan optic fiber in a second curved position 620. In one or moreembodiments, a line tangent to optic fiber distal end 451 may intersecta line tangent to flexible housing tube proximal end 402 at a secondangle, e.g., when optic fiber 450 comprises an optic fiber in a secondcurved position 620. In one or more embodiments, the second angle maycomprise any angle greater than the first angle. For example, the secondangle may comprise a 90 degree angle. Illustratively, actuation control100 and auto-fixing component 520 may be configured to temporarily fixactuation control 100 in a third fixed rotational position within handleinner portion 240. In one or more embodiments, optic fiber 450 maycomprise an optic fiber in a second curved position 620, e.g., whenactuation control 100 is fixed in the third fixed rotational positionwithin handle inner portion 240.

FIG. 6D illustrates an optic fiber in a third curved position 630. Inone or more embodiments, a rotation of actuation control 100 withinhandle inner portion 240 may be configured to gradually curve opticfiber 450 from an optic fiber in a second curved position 620 to anoptic fiber in a third curved position 630. Illustratively, a rotationof actuation control 100 within handle inner portion 240 may beconfigured to retract cable 410 relative to flexible housing tube 400.In one or more embodiments, a retraction of cable 410 relative toflexible housing tube 400 may be configured to apply a force to aportion of flexible housing tube 400. Illustratively, an application ofa force to a portion of flexible housing tube 400 may be configured tocompress a portion of flexible housing tube 400. In one or moreembodiments, a compression of a portion of flexible housing tube 400 maybe configured to gradually curve flexible housing tube 400.Illustratively, a gradual curving of flexible housing tube 400 may beconfigured to gradually curve optic fiber 450, e.g., from an optic fiberin a second curved position 620 to an optic fiber in a third curvedposition 630. In one or more embodiments, a line tangent to optic fiberdistal end 451 may intersect a line tangent to flexible housing tubeproximal end 402 at a third angle, e.g., when optic fiber 450 comprisesan optic fiber in a third curved position 630. In one or moreembodiments, the third angle may comprise any angle greater than thesecond angle. For example, the third angle may comprise a 135 degreeangle. Illustratively, actuation control 100 and auto-fixing component520 may be configured to temporarily fix actuation control 100 in afourth fixed rotational position within handle inner portion 240. In oneor more embodiments, optic fiber 450 may comprise an optic fiber in athird curved position 630, e.g., when actuation control 100 is fixed inthe fourth fixed rotational position within handle inner portion 240.

FIG. 6E illustrates an optic fiber in a fourth curved position 640. Inone or more embodiments, a rotation of actuation control 100 withinhandle inner portion 240 may be configured to gradually curve opticfiber 450 from an optic fiber in a third curved position 630 to an opticfiber in a fourth curved position 640. Illustratively, a rotation ofactuation control 100 within handle inner portion 240 may be configuredto retract cable 410 relative to flexible housing tube 400. In one ormore embodiments, a retraction of cable 410 relative to flexible housingtube 400 may be configured to apply a force to a portion of flexiblehousing tube 400. Illustratively, an application of a force to a portionof flexible housing tube 400 may be configured to compress a portion offlexible housing tube 400. In one or more embodiments, a compression ofa portion of flexible housing tube 400 may be configured to graduallycurve flexible housing tube 400. Illustratively, a gradual curving offlexible housing tube 400 may be configured to gradually curve opticfiber 450, e.g., from an optic fiber in a third curved position 630 toan optic fiber in a fourth curved position 640. In one or moreembodiments, a line tangent to optic fiber distal end 451 may beparallel to a line tangent to flexible housing tube proximal end 402,e.g., when optic fiber 450 comprises an optic fiber in a fourth curvedposition 640. Illustratively, actuation control 100 and auto-fixingcomponent 520 may be configured to temporarily fix actuation control 100in a fifth fixed rotational position within handle inner portion 240. Inone or more embodiments, optic fiber 450 may comprise an optic fiber ina fourth curved position 640, e.g., when actuation control 100 is fixedin the fifth fixed rotational position within handle inner portion 240.

In one or more embodiments, one or more properties of a steerable laserprobe may be adjusted to attain one or more desired steerable laserprobe features. Illustratively, a distance that flexible housing tubedistal end 401 extends from handle distal end 301 may be adjusted tovary an amount of rotation of actuation control 100 configured to curveflexible housing tube 400 to a particular curved position. In one ormore embodiments, a stiffness of flexible housing tube 400 may beadjusted to vary an amount of rotation of actuation control 100configured to curve flexible housing tube 400 to a particular curvedposition. Illustratively, a material comprising flexible housing tube400 may be adjusted to vary an amount of rotation of actuation control100 configured to curve flexible housing tube 400 to a particular curvedposition. In one or more embodiments, a stiffness of flexible housingtube 400 may be adjusted to vary a bend radius of flexible housing tube400. Illustratively, a stiffness of flexible housing tube 400 may beadjusted to vary a radius of curvature of flexible housing tube 400,e.g., when flexible housing tube 400 is in a particular curved position.

In one or more embodiments, at least a portion of optic fiber 450 may beenclosed in an optic fiber sleeve configured to, e.g., protect opticfiber 450, vary a stiffness of optic fiber 450, vary an optical propertyof optic fiber 450, etc. Illustratively, optic fiber 450 may comprise abuffer, a cladding disposed in the buffer, and a core disposed in thecladding. In one or more embodiments, at least a portion of optic fiber450 may comprise a buffer configured to protect an optical property ofoptic fiber 450. Illustratively, at least a portion of optic fiber 450may comprise a buffer configured to protect an optical layer of opticfiber 450, e.g., the buffer may protect an optical layer of a curvedportion of optic fiber 450. In one or more embodiments, at least aportion of optic fiber 450 may comprise a polyimide buffer configured toprotect an optical property of optic fiber 450. For example, at least aportion of optic fiber 450 may comprise a Kapton buffer configured toprotect an optical property of optic fiber 450.

In one or more embodiments, a location wherein cable 410 may be fixed toflexible housing tube 400 may be adjusted to vary an amount of rotationof actuation control 100 configured to curve flexible housing tube 400to a particular curved position. For example, a portion of cable 410 maybe fixed to an outer portion of flexible housing tube 400.Illustratively, cable 410 may be fixed to flexible housing tube 400 at aplurality of fixation points, e.g., to vary one or more properties of asteerable laser probe. In one or more embodiments, a length of cable 410may be adjusted to vary an amount of rotation of actuation control 100configured to curve flexible housing tube 400 to a particular curvedposition. Illustratively, a steerable laser probe may comprise one ormore redundant cables 410. In one or more embodiments, one or moreredundant cables 410 may be configured to maintain a particular curvedposition of flexible housing tube 400, e.g., in the event that cable 410breaks or fails. Illustratively, one or more redundant cables 410 may beconfigured to maintain a particular curved position of flexible housingtube 400, e.g., in the event that a cable 410 fixation means fails. Inone or more embodiments, one or more redundant cables 410 may beconfigured to maintain a particular curved position of flexible housingtube 400, e.g., in the event that cable 410 is no longer configured tomaintain the particular curved position of flexible housing tube 400.Illustratively, one or more redundant cables 410 may be configured tomaintain a particular curved position of flexible housing tube 400wherein cable 410 is also configured to maintain the particular curvedposition of flexible housing tube 400.

In one or more embodiments, flexible housing tube 400 may comprise anaccess window configured to allow access to a portion cable 410.Illustratively, cable 410 may be fixed to a portion of flexible housingtube 400, e.g., by looping a portion of cable 410 through an aperture inflexible housing tube 400. In one or more embodiments, cable 410 may befixed to a portion of flexible housing tube 400, e.g., by a purelymechanical means. For example, cable 410 may be fixed to a portion offlexible housing tube 400 in a manner other than by an adhesive, a weld,etc. Illustratively, cable 410 may be fixed to a portion of flexiblehousing tube 400 wherein a portion of cable 410 is configured to fail ata first applied failure force and a fixation means that fixes a portionof cable 410 to a portion of flexible housing tube 400 is configured tofail at a second applied failure force. In one or more embodiments, thesecond applied failure force may be greater than the first appliedfailure force.

Illustratively, an arrangement of a portion of cable 410, e.g., anarrangement of a portion of cable 410 between cable distal end 411 andcable proximal end 412, may be adjusted to attain one or more desiredsteerable laser probe features. In one or more embodiments, anarrangement of a portion of cable 410 may be configured to cause arotation of actuation control 100, e.g., a rotation of actuation control100 due to force vector applied to actuation control anterior end 103and directed towards handle distal end 301 and away from handle proximalend 302, to retract cable 410 relative to flexible housing tube 400.Illustratively, an arrangement of a portion of cable 410 may beconfigured to cause a rotation of actuation control 100, e.g., arotation of actuation control 100 due to force vector applied toactuation control anterior end 103 and directed towards handle proximalend 302 and away from handle distal end 301, to extend cable 410relative to flexible housing tube 400. In one or more embodiments, cable410 may be disposed within actuation chamber 130, e.g., cable 410 mayingress actuation chamber 130 at actuation control distal end 101, andthen disposed within cable housing 120. Illustratively, cable 410 may bedisposed within actuation chamber 130, e.g., cable 410 may be disposedover actuation control posterior end 104 and ingress actuation chamber130 at actuation control proximal end 102, and then disposed withincable housing 120. In one or more embodiments, cable 410 may not bedisposed within actuation chamber 130, e.g., cable 410 may be disposedover actuation control posterior end 104 and actuation control proximalend 102, and then disposed within cable housing 120.

Illustratively, an arrangement of a portion of cable 410 may beconfigured to cause a rotation of actuation control 100, e.g., arotation of actuation control 100 due to force vector applied toactuation control anterior end 103 and directed towards handle proximalend 302 and away from handle distal end 301, to retract cable 410relative to flexible housing tube 400. In one or more embodiments, anarrangement of a portion of cable 410 may be configured to cause arotation of actuation control 100, e.g., a rotation of actuation control100 due to force vector applied to actuation control anterior end 103and directed towards handle distal end 301 and away from handle proximalend 302, to extend cable 410 relative to flexible housing tube 400. Forexample, cable 410 may be disposed over a portion of actuation control100 between actuation control distal end 101 and actuation controlanterior end 103, and then disposed within cable housing 120.

Illustratively, a steerable laser probe may be configured to indicate,e.g., to a surgeon, a direction that optic fiber 450 may curve, e.g.,due to a rotation of actuation control 100 within handle inner portion240. In one or more embodiments, a portion of a steerable laser probe,e.g., handle 300, may be marked in a manner configured to indicate adirection that optic fiber 450 may curve. For example, a portion offlexible housing tube 400 may comprise a mark configured to indicate adirection that optic fiber 450 may curve. Illustratively, flexiblehousing tube 400 may comprise a slight curve, e.g., a curve less than7.5 degrees, when cable 410 is fully extended relative to flexiblehousing tube 400. For example, flexible housing tube 400 may comprise aslight curve, e.g., a curve greater than 7.5 degrees, when cable 410 isfully extended relative to flexible housing tube 400. In one or moreembodiments, flexible housing tube 400 may comprise a slight curveconfigured to indicate a direction that optic fiber 450 may curve, e.g.,due to a rotation of actuation control 100 within handle inner portion240.

FIGS. 7A, 7B, 7C, 7D, and 7E are schematic diagrams illustrating agradual straightening of an optic fiber 450. FIG. 7A illustrates a fullycurved optic fiber 700. In one or more embodiments, optic fiber 450 maycomprise a fully curved optic fiber 700, e.g., when cable 410 is fullyretracted relative to flexible housing tube 400. In one or moreembodiments, a line tangent to optic fiber distal end 451 may beparallel to a line tangent to flexible housing tube proximal end 402,e.g., when optic fiber 450 comprises a fully curved optic fiber 700.

FIG. 7B illustrates an optic fiber in a first partially straightenedposition 710. In one or more embodiments, a rotation of actuationcontrol 100 within handle inner portion 240 may be configured togradually straighten optic fiber 450 from a fully curved optic fiber 700to an optic fiber in a first partially straightened position 710.Illustratively, a rotation of actuation control 100 within handle innerportion 240 may be configured to extend cable 410 relative to flexiblehousing tube 400. In one or more embodiments, an extension of cable 410relative to flexible housing tube 400 may be configured to reduce aforce applied to flexible housing tube 400. Illustratively, a reductionof a force applied to a portion of flexible housing tube 400 may beconfigured to decompress a portion of flexible housing tube 400. In oneor more embodiments, a decompression of a portion of is flexible housingtube 400 may be configured to gradually straighten flexible housing tube400. Illustratively, a gradual straightening of flexible housing tube400 may be configured to gradually straighten optic fiber 450, e.g.,from a fully curved optic fiber 700 to an optic fiber in a firstpartially straightened position 710. In one or more embodiments, a linetangent to optic fiber distal end 451 may intersect a line tangent toflexible housing tube proximal end 402 at a first partially straightenedangle, e.g., when optic fiber 450 comprises an optic fiber in a firstpartially straightened position 710. Illustratively, the first partiallystraightened angle may comprise any angle less than 180 degrees. Forexample, the first partially straightened angle may comprise a 135degree angle.

FIG. 7C illustrates an optic fiber in a second partially straightenedposition 720. In one or more embodiments, a rotation of actuationcontrol 100 within handle inner portion 240 may be configured togradually straighten optic fiber 450 from an optic fiber in a firstpartially straightened position 710 to an optic fiber in a secondpartially straightened position 720. Illustratively, a rotation ofactuation control 100 within handle inner portion 240 may be configuredto extend cable 410 relative to flexible housing tube 400. In one ormore embodiments, an extension of cable 410 relative to flexible housingtube 400 may be configured to reduce a force applied to flexible housingtube 400. Illustratively, a reduction of a force applied to a portion offlexible housing tube 400 may be configured to decompress a portion offlexible housing tube 400. In one or more embodiments, a decompressionof a portion of flexible housing tube 400 may be configured to graduallystraighten flexible housing tube 400. Illustratively, a gradualstraightening of flexible housing tube 400 may be configured togradually straighten optic fiber 450, e.g., from an optic fiber in afirst partially straightened position 710 to an optic fiber in a secondpartially straightened position 720. In one or more embodiments, a linetangent to optic fiber distal end 451 may intersect a line tangent toflexible housing tube proximal end 402 at a second partiallystraightened angle, e.g., when optic fiber 450 comprises an optic fiberin a second partially straightened position 720. Illustratively, thesecond partially straightened angle may comprise any angle less than thefirst partially straightened angle. For example, the second partiallystraightened angle may comprise a 90 degree angle.

FIG. 7D illustrates an optic fiber in a third partially straightenedposition 730. In one or more embodiments, a rotation of actuationcontrol 100 within handle inner portion 240 may be configured togradually straighten optic fiber 450 from an optic fiber in a secondpartially straightened position 720 to an optic fiber in a thirdpartially straightened position 730. Illustratively, a rotation ofactuation control 100 within handle inner portion 240 may be configuredto extend cable 410 relative to flexible housing tube 400. In one ormore embodiments, an extension of cable 410 relative to flexible housingtube 400 may be configured to reduce a force applied to flexible housingtube 400. Illustratively, a reduction of a force applied to a portion offlexible housing tube 400 may be configured to decompress a portion offlexible housing tube 400. In one or more embodiments, a decompressionof a portion of flexible housing tube 400 may be configured to graduallystraighten flexible housing tube 400. Illustratively, a gradualstraightening of flexible housing tube 400 may be configured togradually straighten optic fiber 450, e.g., from an optic fiber in asecond partially straightened position 720 to an optic fiber in a thirdpartially straightened position 730. In one or more embodiments, a linetangent to optic fiber distal end 451 may intersect a line tangent toflexible housing tube proximal end 402 at a third partially straightenedangle, e.g., when optic fiber 450 comprises an optic fiber in a thirdpartially straightened position 730. Illustratively, the third partiallystraightened angle may comprise any angle less than the second partiallystraightened angle. For example, the third partially straightened anglemay comprise a 45 degree angle.

FIG. 7E illustrates an optic fiber in a fully straightened position 740.In one or more embodiments, a rotation of actuation control 100 withinhandle inner portion 240 may be configured to gradually straighten opticfiber 450 from an optic fiber in a third partially straightened position730 to an optic fiber in a fully straightened position 740.Illustratively, a rotation of actuation control 100 within handle innerportion 240 may be configured to extend cable 410 relative to flexiblehousing tube 400. In one or more embodiments, an extension of cable 410relative to flexible housing tube 400 may be configured to reduce aforce applied to flexible housing tube 400. Illustratively, a reductionof a force applied to a portion of flexible housing tube 400 may beconfigured to decompress a portion of flexible housing tube 400. In oneor more embodiments, a decompression of a portion of flexible housingtube 400 may be configured to gradually straighten flexible housing tube400. Illustratively, a gradual straightening of flexible housing tube400 may be configured to gradually straighten optic fiber 450, e.g.,from an optic fiber in a third partially straightened position 730 to anoptic fiber in a fully straightened position 740. In one or moreembodiments, a line tangent to optic fiber distal end 451 may beparallel to a line tangent to flexible housing tube proximal end 402,e.g., when optic fiber 450 comprises an optic fiber in a fullystraightened position 740.

Illustratively, a surgeon may aim optic fiber distal end 451 at any of aplurality of targets within an eye, e.g., to perform a photocoagulationprocedure, to illuminate a surgical target site, etc. In one or moreembodiments, a surgeon may aim optic fiber distal end 451 at any targetwithin a particular transverse plane of the inner eye by, e.g., rotatinghandle 300 to orient flexible housing tube 400 in an orientationconfigured to cause a curvature of flexible housing tube 400 within theparticular transverse plane of the inner eye and varying an amount ofrotation of actuation control 100 within handle inner portion 240.Illustratively, a surgeon may aim optic fiber distal end 451 at anytarget within a particular sagittal plane of the inner eye by, e.g.,rotating handle 300 to orient flexible housing tube 400 in anorientation configured to cause a curvature of flexible housing tube 400within the particular sagittal plane of the inner eye and varying anamount of rotation of actuation control 100 within handle inner portion240. In one or more embodiments, a surgeon may aim optic fiber distalend 451 at any target within a particular frontal plane of the inner eyeby, e.g., varying an amount of rotation of actuation control 100 withinhandle inner portion 240 to orient a line tangent to optic fiber distalend 451 wherein the line tangent to optic fiber distal end 451 is withinthe particular frontal plane of the inner eye and rotating handle 300.Illustratively, a surgeon may aim optic fiber distal end 451 at anytarget located outside of the particular transverse plane, theparticular sagittal plane, and the particular frontal plane of the innereye, e.g., by varying a rotational orientation of handle 300 and varyingan amount of rotation of actuation control 100 within handle innerportion 240. In one or more embodiments, a surgeon may aim optic fiberdistal end 451 at any target of a plurality of targets within an eye,e.g., without increasing a length of a portion of a steerable laserprobe within the eye. Illustratively, a surgeon may aim optic fiberdistal end 451 at any target of a plurality of targets within an eye,e.g., without decreasing a length of a portion of a steerable laserprobe within the eye.

The foregoing description has been directed to particular embodiments ofthis invention. It will be apparent; however, that other variations andmodifications may be made to the described embodiments, with theattainment of some or all of their advantages. Specifically, it shouldbe noted that the principles of the present invention may be implementedin any system. Furthermore, while this description has been written interms of a surgical instrument, the teachings of the present inventionare equally suitable to any systems where the functionality may beemployed. Therefore, it is the object of the appended claims to coverall such variations and modifications as come within the true spirit andscope of the invention.

What is claimed is:
 1. An instrument comprising: a handle having ahandle distal end and a handle proximal end; an actuation control havingan actuation control distal end, an actuation control proximal end, anactuation control anterior end, an actuation control posterior end, anda fixation pin guide, the actuation control at least partially disposedwithin an inner portion of the handle wherein the actuation controlanterior end extends out from the inner portion of the handle and theactuation control posterior end extends out from the inner portion ofthe handle; a fixation pin disposed in the fixation pin guide and aportion of the handle wherein the actuation control is configured torotate about the fixation pin within the inner portion of the handle ina first direction and wherein the actuation control is configured torotate about the fixation pin within the inner portion of the handle ina second direction; a single flexible housing tube having a flexiblehousing tube distal end and a flexible housing tube proximal end, theflexible housing tube having dimensions configured for performingophthalmic surgical procedures through a cannula; an optic fiber havingan optic fiber distal end and an optic fiber proximal end, the opticfiber disposed within the inner portion of the handle, the flexiblehousing tube, and an actuation chamber of the actuation control whereinthe optic fiber distal end is adjacent to the flexible housing tubedistal end and wherein a portion of the optic fiber is fixed to aportion of the flexible housing tube and wherein the actuation chamberextends from the actuation control distal end to the actuation controlproximal end to prevent a contact between the actuation control and theoptic fiber; and an auto-fixing component having an auto-fixingcomponent distal end and an auto-fixing component proximal end, theauto-fixing component configured to temporarily fix the actuationcontrol in a first rotational position about the fixation pin within theinner portion of the handle in the first direction, the auto-fixingcomponent disposed in an auto-fixing component housing of the handlewherein a portion of the auto-fixing component is adjacent to a portionof the actuation control.
 2. The instrument of claim 1 wherein a firstrotation of the actuation control within the inner portion of the handlein the first direction is configured to gradually curve the optic fiberto a first curved position relative to the flexible housing tubeproximal end.
 3. The instrument of claim 2 wherein the auto-fixingcomponent is configured to temporarily fix the actuation control in asecond rotational position about the fixation pin within the innerportion of the handle in the first direction.
 4. The instrument of claim3 wherein the auto-fixing fixing component is configured to temporarilyfix the optic fiber in the first curved position relative to theflexible housing tube proximal end.
 5. The instrument of claim 4 whereina second rotation of the actuation control within the inner portion ofthe handle in the first direction is configured to curve the optic fiberto a second curved position relative to the flexible housing tubeproximal end.
 6. The instrument of claim 5 wherein the auto-fixingcomponent is configured to temporarily fix the actuation control in athird rotational position about the fixation pin within the innerportion of the handle in the first direction.
 7. The instrument of claim6 wherein the auto-fixing component is configured to temporarily fix theoptic fiber in the second curved position relative to the flexiblehousing tube proximal end.
 8. The instrument of claim 1 furthercomprising: an actuation chamber of the actuation control wherein theoptic fiber is disposed within the actuation chamber and the actuationchamber is configured to prevent a contact between the actuation controland the optic fiber.
 9. The instrument of claim 8 wherein a geometry ofthe actuation chamber is configured to prevent the contact between theactuation control and the optic fiber.
 10. The instrument of claim 1wherein the flexible housing tube is manufactured from Nitinol.
 11. Theinstrument of claim 1 wherein the flexible housing tube is manufacturedfrom a material having an ultimate tensile strength in a range of 700 to1000 MPa.
 12. The instrument of claim 1 wherein the flexible housingtube is manufactured from a material having a modulus of elasticity in arange of 30 to 80 GPa.
 13. The instrument of claim 1 wherein theflexible housing tube has an ultimate tensile strength in a range of1000 to 1100 MPa.
 14. The instrument of claim 1 further comprising: acable housing of the actuation control; and a cable having a cabledistal end and a cable proximal end wherein the cable distal end isdisposed within the flexible housing tube and the cable proximal end isdisposed in the cable housing.
 15. The instrument of claim 2 wherein asecond rotation of the actuation control within the inner portion of thehandle in the second direction is configured to gradually straighten theoptic fiber relative to a first straightened position relative to theflexible housing tube proximal end.
 16. The instrument of claim 1further comprising: an actuation control mount having an actuationcontrol mount distal end and an actuation control mount proximal end,the actuation control mount disposed within the inner portion of thehandle.